Individual provider Active NPI

Xing-Xing Luo, MD

  • Psychiatry Physician
  • Fairfield, CA
National Provider Identifier
1316025216
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A73788 Issued in CA
Practice address
2101 Courage Dr
Fairfield, CA 94533-6717
Phone
(707) 784-2080
NPI assigned
Nov 1, 2006
Last updated
Feb 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A73788 CA Primary

Addresses

Primary practice location

2101 Courage Dr
Fairfield, CA 94533-6717

Mailing address

2101 Courage Dr
Fairfield, CA 94533-6717
Phone (707) 784-2080

Other identifiers 1

IdentifierTypeStateIssuer
00A737880MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071010000869 CA Practitioner - Psychiatry 9931295649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of SolanoGroup PAC ID 7911893177, 30 clinicians

Practice addresses (Care Compare)

2101 Courage Dr
Fairfield, CA 94533-6717
Phone (707) 784-2120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
73788CAMDPharmacist
A73788CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Solano CurrentSince Sep 15, 2015 Accepting new patients
County of Solano Current Accepting new patients
County of Solano CurrentSince Sep 15, 2015 Accepting new patients

Locations

2101 Courage Dr
Fairfield, CA 94533
Phone (707) 428-1131

275 Beck Ave
#5
Fairfield, CA 94533
Phone (707) 784-8362

275 Beck Ave
#5210
Fairfield, CA 94533
Phone (707) 784-8315

228 Broadway St
Vallejo, CA 94590
Phone (707) 553-5331

355 Tuolumne St
Vallejo, CA 94590
Phone (707) 553-5331

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1316025216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 COURAGE DR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945336717",
            "telephone_number": "707-784-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 COURAGE DR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945336717",
            "telephone_number": "707-784-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUO",
        "first_name": "XING-XING",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A73788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A737880",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.